FAC Explorer

Audit 20416

FY End
2022-03-31
Total Expended
$56.56M
Findings
4
Programs
22
Organization: Sea Mar Community Health Center and Subsidiaries (WA)
Year: 2022 Accepted: 2022-11-14
Auditor: Moss Adams

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
16529 2022-001 Material Weakness Yes N
16530 2022-001 Material Weakness Yes N
592971 2022-001 Material Weakness Yes N
592972 2022-001 Material Weakness Yes N

Programs

ALN Program Spent Major Findings
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $22.36M Yes 1
93.498 Provider Relief Fund $5.84M Yes 0
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $4.24M - 0
21.023 Emergency Rental Assistance Program $1.65M Yes 0
10.405 Farm Labor Housing Loans and Grants $1.64M - 0
93.247 Advanced Nursing Education Grant Program $882,869 - 0
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $620,396 - 0
93.243 Substance Abuse and Mental Health Services_projects of Regional and National Significance $596,416 - 0
10.427 Rural Rental Assistance Payments $376,666 - 0
16.838 Comprehensive Opioid Abuse Site-Based Program $345,367 - 0
93.525 State Planning and Establishment Grants for the Affordable Care Act (aca)?s Exchanges $337,999 - 0
93.788 Opioid Str $70,909 - 0
93.778 Medical Assistance Program $47,965 - 0
97.010 Citizenship Education and Training $44,380 - 0
14.267 Continuum of Care Program $42,013 - 0
10.558 Child and Adult Care Food Program $40,222 - 0
10.555 National School Lunch Program $37,233 - 0
94.006 Americorps $35,233 - 0
93.045 Special Programs for the Aging_title Iii, Part C_nutrition Services $34,997 - 0
93.283 Centers for Disease Control and Prevention_investigations and Technical Assistance $31,331 - 0
93.261 National Diabetes Prevention Program: Preventing Type 2 Diabetes Among People at High Risk $24,055 - 0
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $14,177 - 0

Contacts

Name Title Type
HDKAKDQ1KLQ6 1040 S Henderson St. Auditee
4256289987 Mary Wright Auditor
No contacts on file

Notes to SEFA

Title: Note 1 Basis of Presentation Accounting Policies: Note 2 Summary of Significant Accounting PoliciesExpenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. Pass-through entity identifying numbers are presented where available. De Minimis Rate Used: N Rate Explanation: Note 3 Indirect Costs The Organization has not elected to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. Note 1 Basis of Presentation The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal grant activity of Sea Mar Community Health Center and Subsidiaries (the Organization) under programs of the federal government for the year ended March 31, 2022. The information in this Schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the Schedule presents only a selected portion of the operations of Sea Mar Community Health Center and Subsidiaries, it is not intended to, and does not, present the financial position, changes in net assets or cash flows of Sea Mar Community Health Center and Subsidiaries. Therefore, some amounts presented in this schedule may differ from amounts presented in, or used in the preparation of the consolidated financial statements. The following is a reconciliation of the difference for the year ended March 31, 2022: Total expenditures of federal awards $ 56,555,779. Less: Federal loan balances outstanding, beginning of year (1,641,886)Add: Nonfederal grants and contract revenue 21,078,219. Total grants and contracts revenue per accompanying consolidated statement of activities and changes in net assets $ 75,992,112.
Title: Note 4 Loans Outstanding Accounting Policies: Note 2 Summary of Significant Accounting PoliciesExpenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. Pass-through entity identifying numbers are presented where available. De Minimis Rate Used: N Rate Explanation: Note 3 Indirect Costs The Organization has not elected to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. Note 4 Loans OutstandingSea Mar Community Health Center and Subsidiaries have the following loan balances outstanding at the end of fiscal year 2022. Federal Assistance Amount Listing Number Outstanding U.S. Department of Agriculture Farm Labor Housing Loans and Grants 10.405 $1,569,363.
Title: Note 5 Amounts Provided to Subrecipients Accounting Policies: Note 2 Summary of Significant Accounting PoliciesExpenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. Pass-through entity identifying numbers are presented where available. De Minimis Rate Used: N Rate Explanation: Note 3 Indirect Costs The Organization has not elected to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. Note 5 Amounts Provided to SubrecipientsNo amounts were provided to subrecipients under programs of the federal government for the year ended March 31, 2022.

Finding Details

Finding 2022-001
III. FEDERAL AWARD FINDINGS AND QUESTIONED COSTS Finding 2022-001 Special Tests and Provisions ? Material Weakness in Internal Control over Compliance Program: U.S Department of Health and Human Services Health Center Program Cluster: ALN 93.22/93.527. Award Number: Various. Award Year: 2022, 2023. Criteria: In accordance with the Health Resources & Services Administration Health Center Program Compliance Manual, Chapter 9: Sliding Fee Discount Program, health centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted based on the patients? ability to pay. Condition/Cause: The Health Center did not retain underlying data in accordance with policy to support the sliding fee scale discount based on the patients? family size or income. Additionally, the Health Center had instances in which discounts were not applied accurately based on the underlying support that was provided by the patient. The Health Center?s implementation of Epic during the prior year impacted the design and implementation of internal controls over the compliance with respect to the sliding fee discount. Effect: Certain patients may have been billed amounts in excess of and less than the amounts defined by the sliding fee discount schedule. Questioned Costs: Not applicable. Context: We selected 40 patient visits out of the entire population of patients that may be eligible to receive benefits under the program during the fiscal year ended March 31, 2022. In 16 out of 40 samples tested, the Health Center was unable to locate underlying support required per their policy. Repeat Finding: Not applicable. Recommendation: We recommend that further processes and training be put in place to ensure that the sliding fee scale is accurately applied to all qualifying program participants and applicable documentation is retained. Views of Responsible Officials: The Health Center concurs with the finding and is working on implementing the recommendation.
Finding 2022-001
III. FEDERAL AWARD FINDINGS AND QUESTIONED COSTS Finding 2022-001 Special Tests and Provisions ? Material Weakness in Internal Control over Compliance Program: U.S Department of Health and Human Services Health Center Program Cluster: ALN 93.22/93.527. Award Number: Various. Award Year: 2022, 2023. Criteria: In accordance with the Health Resources & Services Administration Health Center Program Compliance Manual, Chapter 9: Sliding Fee Discount Program, health centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted based on the patients? ability to pay. Condition/Cause: The Health Center did not retain underlying data in accordance with policy to support the sliding fee scale discount based on the patients? family size or income. Additionally, the Health Center had instances in which discounts were not applied accurately based on the underlying support that was provided by the patient. The Health Center?s implementation of Epic during the prior year impacted the design and implementation of internal controls over the compliance with respect to the sliding fee discount. Effect: Certain patients may have been billed amounts in excess of and less than the amounts defined by the sliding fee discount schedule. Questioned Costs: Not applicable. Context: We selected 40 patient visits out of the entire population of patients that may be eligible to receive benefits under the program during the fiscal year ended March 31, 2022. In 16 out of 40 samples tested, the Health Center was unable to locate underlying support required per their policy. Repeat Finding: Not applicable. Recommendation: We recommend that further processes and training be put in place to ensure that the sliding fee scale is accurately applied to all qualifying program participants and applicable documentation is retained. Views of Responsible Officials: The Health Center concurs with the finding and is working on implementing the recommendation.
Finding 2022-001
III. FEDERAL AWARD FINDINGS AND QUESTIONED COSTS Finding 2022-001 Special Tests and Provisions ? Material Weakness in Internal Control over Compliance Program: U.S Department of Health and Human Services Health Center Program Cluster: ALN 93.22/93.527. Award Number: Various. Award Year: 2022, 2023. Criteria: In accordance with the Health Resources & Services Administration Health Center Program Compliance Manual, Chapter 9: Sliding Fee Discount Program, health centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted based on the patients? ability to pay. Condition/Cause: The Health Center did not retain underlying data in accordance with policy to support the sliding fee scale discount based on the patients? family size or income. Additionally, the Health Center had instances in which discounts were not applied accurately based on the underlying support that was provided by the patient. The Health Center?s implementation of Epic during the prior year impacted the design and implementation of internal controls over the compliance with respect to the sliding fee discount. Effect: Certain patients may have been billed amounts in excess of and less than the amounts defined by the sliding fee discount schedule. Questioned Costs: Not applicable. Context: We selected 40 patient visits out of the entire population of patients that may be eligible to receive benefits under the program during the fiscal year ended March 31, 2022. In 16 out of 40 samples tested, the Health Center was unable to locate underlying support required per their policy. Repeat Finding: Not applicable. Recommendation: We recommend that further processes and training be put in place to ensure that the sliding fee scale is accurately applied to all qualifying program participants and applicable documentation is retained. Views of Responsible Officials: The Health Center concurs with the finding and is working on implementing the recommendation.
Finding 2022-001
III. FEDERAL AWARD FINDINGS AND QUESTIONED COSTS Finding 2022-001 Special Tests and Provisions ? Material Weakness in Internal Control over Compliance Program: U.S Department of Health and Human Services Health Center Program Cluster: ALN 93.22/93.527. Award Number: Various. Award Year: 2022, 2023. Criteria: In accordance with the Health Resources & Services Administration Health Center Program Compliance Manual, Chapter 9: Sliding Fee Discount Program, health centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted based on the patients? ability to pay. Condition/Cause: The Health Center did not retain underlying data in accordance with policy to support the sliding fee scale discount based on the patients? family size or income. Additionally, the Health Center had instances in which discounts were not applied accurately based on the underlying support that was provided by the patient. The Health Center?s implementation of Epic during the prior year impacted the design and implementation of internal controls over the compliance with respect to the sliding fee discount. Effect: Certain patients may have been billed amounts in excess of and less than the amounts defined by the sliding fee discount schedule. Questioned Costs: Not applicable. Context: We selected 40 patient visits out of the entire population of patients that may be eligible to receive benefits under the program during the fiscal year ended March 31, 2022. In 16 out of 40 samples tested, the Health Center was unable to locate underlying support required per their policy. Repeat Finding: Not applicable. Recommendation: We recommend that further processes and training be put in place to ensure that the sliding fee scale is accurately applied to all qualifying program participants and applicable documentation is retained. Views of Responsible Officials: The Health Center concurs with the finding and is working on implementing the recommendation.